AIELE online Registration AIELE Inscription en Ligne
Email address *
First Name/ Prenom *
Middle Name
Last Name/Nom de Famille *
Date Of Birth/Date de Naissance *
Gender/Sex *
City/ Region *
Street Address/Adresse *
Cell number /Numero de Telephone(Whatsup) *
Are there any medical conditions/allergies or other information the school should be aware of? Conditions medical a signer/ allergies
Type Payment / Mode de Payment
Clear selection
Include transaction fees/Inclure les frais de retrait.
Select a Day for the Test / Choisisse un jour pour le test
Clear selection
Emergency Contact/Qui appeler en cas d'urgence?
Full Name/Nom *
Phone Number/Numero de Telephone *
Relationship/Relation *
A copy of your responses will be emailed to the address you provided.
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